Residents of states that frequently suffer the brunt of hurricanes have grown accustomed to preparations this time of year.
Many people collect batteries, canned food, medication refills, etc. in anticipation of possible long-term power outages when a hurricane strikes. Floridians, for instance, are as accustomed to preparing for hurricanes as they are for tax season. It comes every year and is typically not without its nail-biting moments. Counties throughout Florida and other ‘hurricane states’ begin securing locations to house evacuees well before the season is in swing. They formulate plans on when and how to activate the EOC (Emergency Operations Center). Counties also determine how to evacuate nursing homes in their areas if a hurricane emergency occurs. Officials tweak these plans each year, but they remain fairly consistent otherwise – until this year. How will preparing for hurricanes during COVID-19 affect these strategies?
FEMA on preparing for hurricanes during COVID-19
In the event of a mandatory evacuation, cities typically use public schools for shelters. It is no picnic as hundreds of people cram into tight areas such as gymnasiums or cafeterias. Having worked fire rescue through several hurricanes, I wouldn’t think that “social distancing” is a real option for most evacuees. It would prove especially difficult in heavily populated areas.
FEMA has thus implemented new advisories this year that take COVID-19 into consideration for both responding staff members and the public. FEMA’s guidelines state:
“Field leaders will use modified personnel plans to assess how many personnel will be deployed to field operations and ensure that facility layouts can accommodate CDC guidance and social distancing recommendations.”
FEMA recommends shelter selections be made with considerations such as:
- “Selecting appropriately sized shelter facilities to support CDC guidance and SLTT (State, Local, Tribal and Territorial) public health guidance, social distancing requirements, establishment of isolation areas and cloth face covering distribution.”
- “Developing a plan to conduct health screenings of staff and evacuees for COVID-19 that may enter sheltering locations.”
How nursing homes are preparing for hurricanes during COVID-19
How will COVID-19 affect the evacuations of nursing homes this season? During my time at the fire department, we assisted in evacuating local nursing homes in our “first due” response area. This was a very systematic, but quite rushed process. We were basically loading patient after patient in rotation on the ambulances and taking them to the local hospital or the shelter, depending on their condition. There wasn’t a lot of time to “decontaminate” the ambulance in between. This will, of course, have to change with COVID-19.
The local hospitals usually accommodated the patients that required more medical care. This is typically not a problem since Florida’s hurricane season does not align with their tourism and seasonal residencies; therefore, the hospitals are typically far less stressed during this time. Such is not the case this year, though, due to COVID-19. CNN recently reported nearly 60 ICUs in Florida have reached maximum capacity.
Amanda Plasencia of NBC Miami reports:
“An internal memo obtained from Memorial Healthcare System reported historical highs of coronavirus patients Friday, including ones who are being treated in intensive care. According to the memo obtained by NBC 6, Memorial reported a high of 476 coronavirus patients, up from 357 a week ago. They also reported 62 COVID-19 patients at ICUs.”
She goes on to report that as of the article written on July 10:
“Zero ICU beds are available at North Shore Medical Center, South Miami Hospital and Doctors Hospital in Miami-Dade County, and at Broward Health North, Plantation General Hospital, Memorial Hospital Miramar and University Hospital and Medical Center in Broward County.”
How will a hurricane evacuation further stress the hospitals during this time?
With staff already working around the clock during a pandemic, will they have the staff available to support an evacuation? Worse yet, could they support hurricane-related illnesses and traumatic injuries requiring medical care? I spoke with several nurses that work in the COVID-19 unit of a prominent South Florida hospital. They advised me they are at maximum capacity, and that the CVICU (Cardiovascular ICU) has once again been turned into another COVID-19 ICU. Every bed except for one (at the time of our conversation) was full of patients who are COVID-19 positive and in need of intensive care treatment. How will these providers meet the increased demands of preparing for hurricanes during COVID-19?
The effects on first responders
Palm Beach County Fire Rescue Battalion Chief Mike Reece reports the department will make changes to hurricane evacuation plans with COVID-19 on the rise.
“Up-staffing will be a challenge, as during hurricane emergencies we currently add extra personnel to the brush trucks (which are typically not staffed), raising the number of fire fighters to 32. We also put an additional fire fighter on the rescues which are typically staffed with only two firefighters.”
This may present a challenge, as Palm Beach County Fire Rescue has more than 100 employees on “self-quarantine” due to COVID-19. But, Reece reports they have 100 reservists they can call as “auxiliary first responders to help with the situation.”
He went on to explain protocol for evacuation shelters during a hurricane emergency:
“Evacuees will be much more spread out than in previous years. Schools will be used for shelters with enough area to maintain adequate social distancing. Emergency Management will be checking residents as they enter for temperature or other signs of COVID-19.”
The department will incorporate procedures and changes advised in the above-mentioned FEMA COVID-19 Pandemic Operational Guidelines for the 2020 Hurricane Season to current operational guidelines to ensure the safety of residents and staff, Reece said.
With COVID-19 cases increasing again after many states reopened, healthcare resources have already become stressed to capacity. Experts predict this hurricane season will be a harsh one. So, we must wonder how much more healthcare workers, facilities, and resources can accommodate the possible increase in patients and additional safety measures required. The guidelines produced by FEMA are a great start. Finding a way to flatten the curve of the virus will prove helpful. But, we likely won’t know how stressed the system can get until we face with the situation, no matter how much planning we do.